By Gina Cipriano
According to The Diagnostic and Statistical Manual of Mental Disorders (5th ed.; American Psychiatric Association, 2013), Female Orgasmic Disorder (FOD) is characterized by being unable to achieve or have a lack of intensity regarding orgasm in sexual encounters at least 75% of the time. It is important to note that this must result in considerable distress. Many people have been taught to view achieving orgasm as the indicator of a positive sexual encounter, but a lot of research regarding female orgasm has been conducted by the pharmaceutical industry (Lavie-Ajayi & Joffe, 2009). Lavie-Ajayi’s (2005) research, using interviews, discussed that less than half of the women viewed lack of orgasm as issues for various reasons including relational difficulties, lack of desire, and feelings such as frustration. However, more than half of women interviewed in this study did not view their lack of orgasm as a problem (Lavie-Ajayi, 2005). This being said, it is vital for a person to determine if they are truly distressed by having a lack of orgasm or if society has influenced them to view their lack of orgasm as “dysfunctional” (Lavie-Ajayi, 2005, p. 58).
Nagoski (2015) wrote a book titled, “Come as you are: The surprising new science that will transform your sex life.” For women experiencing any form of sexual dysfunction, this book can assist them in recognizing the cultural narrative that causes them to form a mental picture of what sex “should” look like, help them demystify desire and orgasm, and make them recognize they are not alone in their struggles. Ultimately, discussing with a mental health professional can help a woman outline if being diagnosed with FOD would be empowering or disempowering for them. Sex and pleasure are not a one-size-fits-all approach; each person varies regarding what a positive sex life looks like for them.
In the case of FOD, there are many applicable treatments that can assist a woman in achieving orgasm.
Cognitive Behavioral Therapy: CBT can help a woman determine what thoughts they are having that may influence their behaviors during sex (Ter Kuile et al., 2010). For instance, a woman may think to herself that she is taking too long to achieve orgasm, which results in added pressure and stress during sex. Ultimately, this may lead the woman to shift their focus away from their body, which would negatively affect their ability to achieve orgasm.
Mindfulness: Mindfulness practices can assist a person in becoming aware of the present moment. Ultimately, by calming their nervous system through mindfulness, a woman can prevent themselves from going into fight or flight mode during sex so that they can focus on their pleasure (Nagoski, 2015).
Directed Masturbation: Directed masturbation can assist someone in learning how to develop body awareness (Ter Kuile et al., 2010). For instance, a practitioner can help a client determine what sexual images help arouse them and assist them in tuning into bodily sensation, such as contracting the pelvis, to assist in achieving orgasm (Ter Kuile et al., 2010).
Psychoeducation: Practitioners can provide information on what may assist a woman on achieving orgasm when used in conjunction with other therapies. For instance, mental health practitioners can assist a woman in determining if education on sex toys, communication with sexual partners, and scientific information on a women’s anatomy would assist them in the process of achieving orgasm.
American Psychiatric Association. (2013). Diagnostic and Statistical Manual of Mental Disorders, 5th Edition: DSM-5 (5th ed.). American Psychiatric Publishing.
Lavie-Ajayi, M., & Joffe, H. (2009). Social representations of female orgasm. Journal of Health Psychology, 14(1), 98-107. https://doi.org/10.1177/1359105308097950
Lavie-Ajayi, M. (2005). “Because all real women do”: The construction and deconstruction of “female orgasmic disorder”. Sexualities, Evolution & Gender, 7(1), 57-72. https://doi.org/10.1080/14616660500123664
Nagoski, E. (2015). Come as you are: The surprising new science that will transform your sex life. Scribe Publications.
Ter Kuile, M. M., Both, S., & Van Lankveld, J. J. (2010). Cognitive behavioral therapy for sexual dysfunctions in women. Psychiatric Clinics of North America, 33(3), 595-610. https://doi.org/10.1016/j.psc.2010.04.010
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